10/8/13

How the $9.8 Billion Charge in Healthcare Can Get Better

It's a stunning number -- $9.8 billion dollars annually. This represents how much hospital infections are estimated to be costing us, based on a studyreleased by JAMA. This is just the financial cost. It does not take into account the human factor -- the loss of life and limb associated with infections.

Firstly, infection control has to be a major part of every healthcare treatment plan. The antibiotic resistant bacteria and super viruses are a real risk in hospitals. One primary thing that can be done is to direct appropriate treatment to Ambulatory Surgical Centers (ASCs) which have a much lower and less severe infection rate overall than hospitals. Hospitals have an intrinsic disadvantage. They house sick people as well as offer a place for surgical procedures. Sick people, antibiotic resistant infections, and open wounds are a bad combination.

Secondly, there's the idea of paying for performance vs. paying for service. Under the current model, hospitals make much more when there's an infection than they do when infections are prevented. Inpatient treatments for infections can be very expensive. This is a perverse incentive. Medicare is starting to address this with a reimbursement model change -- not paying for infection-related costs. This makes perfect sense in the private market as well.

It's becoming clear that we must adopt a better model.Rising is already addressing the infection issue with our Surgical Care Program (SCP), which is designed using both of the above solutions. By moving appropriate services out of the hospital setting to free-standing ASCs, directing care to qualified, credentialed surgeons with a great past performance record, and having guaranteed pay for performance in order to ensure better, more affordable healthcare, we can profoundly improve the system.